[Late infection of breast implant, complication of colonic perforation. Review of the literature. Role of preventive treatment].

The authors report a cases of breast implant infection, 40 years after augmentation mammoplasty. The infection developed 6 weeks after colonoscopy complicated by acute peritonitis due to colonic perforation. Bacteroides fragilis, a usual organism of the gastrointestinal tract flora, was identified in the two septic sites (peritoneal and periprosthetic). Contamination of the implant was haematogenous in a context of bacteraemia. Other authors have already suspected this route of contamination without any bacteriological proof. The risk of infection of breast implants is known, but the late infection rate is poorly documented. It is probably very low in view of the rare cases reported in the literature. Breast implants are not at high risk of sepsis, in contrast with prosthetic heart valves. The authors therefore do not recommend any particular preventive treatment in the case of distant infection or dental treatment. Women with breast implants must be informed and reassured: late infection of their implant is possible, but very unlikely. Recognition and prevention of this risk could be based on better long-term follow-up of breast implants.